Cardiovascular system · 38 CFR 4.100-4.104
Cardiovascular Conditions and VA Disability
The cardiovascular system is your heart and blood vessels. The VA rates these conditions under 38 CFR 4.104. High blood pressure, ischemic heart disease, and irregular heartbeats are some of the most claimed, and several are tied to Agent Orange and other toxic exposures from service.
Patriot Path writes the medical piece of these claims. Our physicians write the nexus letters and independent medical opinions that connect your heart or blood-pressure condition to your service. One flat fee of $1,500, and the first consultation is free.
Medically reviewed by the Patriot Path Medical Team
Licensed MD reviewers • Last updated: June 2026
Conditions in this system
These are the cardiovascular conditions veterans claim most. High blood pressure has a full guide now. The rest are on the way.
- High blood pressure (hypertension)
The most claimed cardiovascular condition. Rated on your blood-pressure numbers, and now presumptive for Agent Orange.
DC 7101
- Ischemic heart disease
Coronary artery disease and its effects on the heart. Agent Orange presumptive, and rated on a workload (METs) test.
DC 7005
- Hypertensive heart diseaseGuide in progress
Heart damage caused by long-standing high blood pressure. Rated separately from the hypertension itself.
DC 7007
- Heart valve conditionsGuide in progress
Valvular and rheumatic heart disease, rated on the same workload formula once the diagnosis is confirmed.
DC 7000
- Arrhythmias
Irregular heartbeat, from supraventricular tachycardia to sustained ventricular arrhythmias, rated on how often and how it is treated.
DC 7010-7011
- Peripheral arterial diseaseGuide in progress
Poor circulation in the limbs, rated on objective tests like the ankle-brachial index.
DC 7114
How the VA rates cardiovascular conditions
Most heart conditions use one yardstick: a workload test. It is measured in METs, short for metabolic equivalents. The test looks at how much exertion you can handle before heart-failure symptoms start, like breathlessness, fatigue, chest pain, dizziness, or fainting. The less you can do, the higher the rating. An echocardiogram can also set the level.
High blood pressure is the exception. The VA rates it on your blood-pressure numbers, mainly your diastolic readings (DC 7101). No workload test, just the readings, confirmed over several days.
Here is a detail that helps a lot of veterans. The VA rates high blood pressure separately from heart disease (38 CFR 4.104, Note 3). So if you have both, each can carry its own rating, and the two combine into your overall rating. It is worth knowing before you file.
Connecting a cardiovascular condition to service
There are a few ways to tie a heart or blood-pressure condition to your service:
- Direct. The condition started in service, or an in-service cause led to it. Documented high readings or chest complaints in your records help.
- Presumptive (Agent Orange). Ischemic heart disease and high blood pressure are presumptive for veterans with qualifying Agent Orange exposure. The VA accepts the link, so you do not have to prove the cause.
- Secondary. Another service-connected condition caused or worsened it (38 CFR 3.310). High blood pressure secondary to PTSD, sleep apnea, or kidney disease is a common example.
For a direct or secondary claim, the VA needs a current diagnosis, an in-service cause, and a medical opinion linking them (38 CFR 3.303). That opinion has to clear the “at least as likely as not” standard, a 50% or better chance. That standard is the benefit-of-the-doubt rule under 38 U.S.C. 5107(b), carried out in 38 CFR 3.102. A nexus letter is that linking opinion.
Frequently asked questions
How does the VA rate heart conditions?
Most heart conditions use one yardstick: a workload test measured in METs (metabolic equivalents). It looks at how much exertion you can handle before heart-failure symptoms start, things like breathlessness, fatigue, angina, dizziness, or fainting. Echocardiogram findings can also set the rating. The lower the workload you can manage, the higher the rating. This is the General Rating Formula for Diseases of the Heart under 38 CFR 4.104.
Is high blood pressure a VA disability?
Yes. The VA rates hypertension under 38 CFR 4.104, Diagnostic Code 7101. It is the exception to the workload rule. Hypertension is rated on your blood-pressure numbers, mainly your diastolic readings, confirmed by readings taken two or more times on at least three different days.
Is heart disease or high blood pressure presumptive for Agent Orange?
Both can be. Ischemic heart disease has long been an Agent Orange presumptive condition. The PACT Act of 2022 added high blood pressure (hypertension) to the Agent Orange presumptive list. If you had qualifying exposure, the VA may already accept the link to your service, so you may not need to prove the cause.
Can I get a separate rating for hypertension and heart disease?
Often, yes. This surprises a lot of veterans. The rating schedule says to evaluate hypertension separately from hypertensive heart disease and other heart disease (38 CFR 4.104, DC 7101, Note 3). So a heart condition and high blood pressure can each carry their own rating, which then combine into your overall rating.
Do I need a nexus letter for a cardiovascular claim?
If your condition is presumptive, such as ischemic heart disease or hypertension tied to Agent Orange, you may not. For everything else, especially a condition diagnosed after service or claimed as secondary to PTSD, sleep apnea, or another service-connected problem, a nexus letter is often what decides the claim.
Heart or blood-pressure condition from service?
Tell us what you are dealing with. The first consultation is free, and we will tell you straight whether a nexus letter can strengthen your claim.
Sources & regulatory references
- VA disability compensation (VA.gov) https://www.va.gov/disability/
- 38 CFR 4.104, Schedule of ratings, cardiovascular system (eCFR) https://www.ecfr.gov/current/title-38/section-4.104
- Agent Orange exposure and disability compensation (VA.gov) https://www.va.gov/disability/eligibility/hazardous-materials-exposure/agent-orange/
- 38 CFR 3.310, Secondary service connection (eCFR) https://www.ecfr.gov/current/title-38/section-3.310
- 38 U.S.C. 5107, Benefit of the doubt (Cornell LII) https://www.law.cornell.edu/uscode/text/38/5107
- The PACT Act and your VA benefits (VA.gov) https://www.va.gov/resources/the-pact-act-and-your-va-benefits/